Hard facts about erectile dysfunction


THE statistics are not good if you are an ageing man. The older you get, the greater the probability of you suffering from erectile dysfunction (ED).

The rule of thumb is that in their 20s, 20% will have it; in their 30s, 30% will have it; and in their 40s, 40% will have it.

But as you go beyond 50 years old, the percentage becomes higher. When you reach your 50s, 60% or 70% of men will have this problem. When you are in your 70s, maybe 80% or 90% will have it.


ED used to be known as impotence many years ago. It may sound slightly better to say ED rather than impotence but basically the issue remains the same: An inability to get an erection, or an inability to sustain an erection.

“We’re talking about the inability to get an erection which is sufficient for sexual penetration or for vaginal penetration. That’s all it means,” says consultant clinical andrologist Dr Mohd Ismail Mohd Tambi.

According to him, it can mean the erection is not sufficient for penetration, or that it is enough for penetration but it is not sustainable.

Most senior citizens accept it as a natural part of ageing and very few come forward to get medical help or for advice.

Dr Ismail informs that as we age, our health deteriorates and a man may have health problems like diabetes, high blood pressure or high cholesterol – all of which involve blood circulation. Because of this, one of the symptoms is ED.

Those who don’t have any medical issues and are showing signs of ED should get it checked by a doctor.

Little blue pill

Dr Ismail informs that while some accept ED as part and parcel of ageing, others feel they still want to have sex with their partners. These are the seniors who will seek medical help in the form of medication to enhance blood flow or to use special devices or instruments that can enhance blood flow to the penis and enhance erection such as the vacuum pump or electronic devices.

Pills like Viagra enhance blood flow to the genital area, informs Dr Ismail. They may help, but the effect is not permanent, either.

“These are all pills classified as PDE5 inhibitors and they promote improved blood flow to the penis. But they come with limitations and one of those is the side effects. You get severe headaches, muscle cramps and palpitations.

“The other thing is it might not have any affect at all because this medication only works when you are horny. For a person who has been out of action for a long time, the testosterone level will be low and without an elevated testosterone level, he might not be able to invoke libido and he will not be able to get horny. So, he would not be able to have the desired erection.

“So, you are advised to see a doctor first. Pills like Viagra can’t be bought over the counter either,” he says.

Dr Ismail informs that such pills may be available in the black market but some of them might be fake as well.

He also warns against buying products on the black market as seniors might end up taking drugs which are not suitable for them and may even cause fatality.

Success stories

Dr Ismail reveals that he has patients in their 70s and 80s who are still sexually active with their partners who are in their 60s and 70s.

They are able to have semi-penetrative sex where the man is able to get some form of erection with digital manipulation.

The partial erection is sufficient for the partner to insinuate the penis into the entrance of the vagina.

Alternatives to penetrative sex

Dr Ismail also finds himself educating senior citizens on alternative ways of having sex.

“For those who still have got some romantic feelings and want to have some physical contact, I don’t see any problem. They can still have non-penetrative sex.

“The least you can do is be naked and lie around together. That’s how I look at it. Touching, holding, kneading – that in itself will give you a lot of pleasant feelings, you feel good, you feel good about yourself, you feel good being wanted and needed. And probably the feeling of being touched gives you assurance,” says Dr Ismail.

Traditional methods

He warns seniors about seeking traditional solutions for ED.

According to Dr Ismail both tongkat ali and “urutan batin” (genital massage) do not work. Tongkat ali is just for energy and nothing more, he says.

“Urutan batin might give you a sore penis and nothing more than that,” says Dr Ismail.


The truth is most men who live to a ripe old age will face ED.

There is no way to prevent this from happening. The only thing that might help is to practise an active and healthy lifestyle.

Living in the city, with the accompanying lifestyle is no help because it doesn’t encourage physical activity.

“Everything boils down to your lifestyle. If from the very beginning you maintain a healthy lifestyle like our forefathers who were very strong. Even at an old age they were very virile. Now, we have lost that because of our lifestyle.

“Our forefathers used a lot of movement and had many physical activities. At that time there was not much of mechanisation and automation. Everything they did, they had to rely on their hands, legs and body. Now, we are just a bunch of lazy people, not doing much work, just sitting and watching TV.

“It’s all about your lifestyle,” says Dr Ismail.

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